Foot Disorders Database

Overview The sensation of sore, aching feet or arch pain refers to an inflammation and burning sensation at the arch of the foot. This inflammation is due to the excessive stretching of the fibrous tissue located along the bottom surface of the foot, called plantar fascia. Plantar fascitis is the term named after this condition and described as inflammation of the fascia, muscles and ligaments on the bottom of the foot, causing pain in the heel and arch of the foot.

Causes The cause of this condition is too much pressure exerted on the arches, and although common in athletes, the condition can happen because you went hiking or climbing, you were lifting heavy objects, or you simply walked too far too vigorously. Pregnancy places extra strain on the arches because of both the additional body weight and the effect of hormones on muscles and ligaments.

Symptoms Plantar fasciitis is most often seen in middle-aged men and women, but can be found in all age groups. The condition is diagnosed with the classic symptoms of pain well focused deep in the heel area of the bottom of the foot. Often the pain from plantar fasciitis is most severe when you first stand on your feet in the morning. Pain often subsides quite quickly, but then returns after prolonged standing or walking. Plantar fasciitis is sometimes, but not always, associated with a rapid gain of weight. It is also sometimes seen in recreational athletes, especially runners. In these athletes, it is thought that the repetitive nature of the sports causes the damage to the fibrous tissue that forms the arch of the foot.

Diagnosis After you describe your symptoms and discuss your concerns, your doctor will examine your foot. Your doctor will look for these signs. A high arch. An area of maximum tenderness on the bottom of your foot, just in front of your heel bone. Pain that gets worse when you flex your foot and the doctor pushes on the plantar fascia. The pain improves when you point your toes down. Limited "up" motion of your ankle.

Non Surgical Treatment How the pain in the bottom of your foot is treated will depend heavily on the cause of the pain. Diagnosing the pain while it?s in the early stages is important when determining the best treatment options. If the pain is mild to moderate, simple improvements in footwear can help reduce the symptoms. Most patients must use the RICE method for effective treatment. RICE stands for Rest, Ice, Compression, and Elevation. This is a popular treatment used by athletes. It involves resting the foot, icing it for fifteen to twenty minute intervals, compressing the foot with a bandage, and elevating it at least twelve inches above the heart. Ant-inflammatory and pain medications are also sometimes used to treat bottom-of-foot pain. For more serious cases, steroid injections or foot surgery may help reduce pain and swelling and correct the underlying condition (if there is one.) If you suffer from a severe case of plantar fasciitis and non-surgical methods fail, your doctor may recommend cortisone injections to relieve the pain. If cortisone injections fail, your doctor may recommend a surgical procedure that involves cutting and releasing the plantar fascia.

Surgical Treatment In adults, the most common cause of collapse is due to the posterior tibial tendon tear. In such cases, the tendon must be repaired and a second tendon may be added to the posterior tibial tendon for strength and added support. If the foot is found to be very flat, bone realignment procedures or possible bone fusion procedures may be used to realign the foot. If the calf or Achilles tendon are found to be tight, they may be lengthened to allow better motion at the ankle and less arch strain. The forefoot may also be in a poor position and stabilization of the arch may be necessary to increase forefoot contact to the ground.

Prevention There are several things that you can do to prevent and treat arch pain. This includes Avoiding high heeled shoes, Stretching the calf muscles regularly, Wearing well fitted, comfortable shoes, Using customisedorthotic devices or shoe inserts, Elevating the feet and applying ice and taking over-the-counter anti-inflammatory medications. You can also care for your feet by paying attention to any changes in your feet as you get older. It is normal for feet to lose some of their fat pads as a person ages. Your feet may get bigger, both wider and longer as well. Make sure that you wear shoes that are sturdy, but comfortable, and have your feet measured before you buy shoes to make sure that you are still wearing the right size. Shoe sizes vary from one brand to the next, so it is a good idea to have your feet measured every time you purchase shoes. When choosing shoes, match the shoe to the activity for which it will be worn. Within the broader grouping of athletic shoes, there are different categories with different features. For example, a running shoe has different features than a walking shoe. You may develop some arthritic changes in your feet over time, too. If you notice that you are experiencing more pain in your feet, see your doctor for an evaluation. If the pain is arthritis-related, your doctor may recommend medication or other treatment to slow the progression of the arthritis.

Stretching Exercises Plantar Fasciitis stretches should always be gentle and pain free, if discomfort occurs with or after stretching decrease the intensity and duration of stretches. Stretches can usually be gradually progressed in intensity and duration over time according to individual tolerance. Plantar Fasciitis Stretch 1. Stretch for the right calf muscle (gastrocnemius) and the arch of the right foot (plantar fascia and muscles under the arches). Take your right heel close to the wall and ball of the foot upright against the wall. Move your hips forwards to the wall. Try to keep your right leg straight. Push down through your right heel to increase the stretch. Maintain for 30 seconds, repeat 2-3 times. Plantar Fasciitis Stretch 2. Stretch for the outside belly of the right calf muscle and the arch of the right foot. Take your right heel close to the wall. Turn the ball of your right foot outwards to 2 o?clock position upright against the wall. Move your hips forwards to the wall. Turn your trunk in the opposite direction (i.e. to the left). Try to keep your right leg straight. Push down through your right heel to increase the stretch. Maintain for 30 seconds, repeat 2-3 times. Plantar Fasciitis Stretch 3. Stretch for the inside belly of the right calf muscle and the arch of the right foot. Take your right heel close to the wall. Turn the ball of your right foot inwards to 10 o?clock position upright against the wall. Move your hips forwards to the wall. Turn your trunk in the opposite direction (i.e. to the right). Try to keep your right leg straight. Push down through your right heel to increase the stretch. Maintain for 30 seconds, repeat 2-3 times. Plantar Fasciitis Stretch 4. Stretch for the right achilles tendon and the arch of the right foot. Take your right heel close to the wall and ball of the foot upright against the wall (as for stretch 1). Move your hips forwards to the wall. Bend your right knee forwards into the wall keeping the ball of your foot upright against the wall. Push down through your right heel to increase the stretch. Maintain for 30 seconds, repeat 2-3 times.